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Questions 71-80

71. Coeliac disease

a. Results from dietary glucose intolerance

b. Is associated with increased serum anti-endomysial and anti-gliadin antibodies

c. Small bowel histology shows villous hypertrophy

d. Can be effectively treated with a gluten-free diet

e. Increases the risk of small bowel lymphoma

72. Papillary carcinoma of the thyroid

a. Can be reliably diagnosed using fine needle aspiration cytology

b. Is almost always unifocal

c. Histologically displays Psammoma bodies

d. Typically spread to the cervical lymph nodes

e. Requires a total thyroidectomy for large tumours

73. Regarding bladder tumours

a. 90% are squamous carcinomas

b. Painless haematuria is the commonest presentation

c. Cigarette smoking is an important aetiological factor

d. 80% of tumours are superficial (i.e. no muscle invasion)

e. Superficial tumours are often well controlled by transurethral resection

74. The following are carcinogens important in bladder cancer

a. Magenta

b. Auramine

c. Benzidine

d. Beta-naphthylamine

e. Chlorinated hydrocarbons

75. Regarding ureteric calculi

a. Are most often composed of calcium oxalate or phosphate

b. Less than 5% of those less than 5 mm in diameter pass spontaneously

c. Extracorporeal lithotripsy is useful for stones in the upper third of the ureter

d. About 30% of patients require open surgery to remove the stone

e. An obstructed ureter in the presence of infection is a surgical emergency

76. Cryptorchidism

a. Occurs in 5% of newborn boys

b. Increases risk of malignancy by a factor of ten

c. Is associated with normal fertility

d. Laparoscopy is the best means of identifying an impalpable testis

e. Should be treated by orchidopexy at puberty

77. Regarding small bowel obstruction

a. In the United Kingdom is most often due to an obstructed hernia

b. Causes colicky abdominal pain and vomiting

c. Abdominal distension is seen in all patients

d. All cases can be managed conservatively for the first 24 hours

e. Rarely requires aggressive fluid resuscitation

78. Regarding bone scintigraphy

a. It is less sensitive than radiographs in detecting metastatic bone disease

b. It is performed using technetium labeled biphosphonates

c. The radiation dose received is equivalent to a CT scan

d. Renal excretion of the isotope can cause false positive images

e. Has a high risk of anaphylaxis

79. Regarding nephroblastomas

a. They are otherwise known as a Wilm's tumour

b. Account for 10% of childhood tumours

c. The commonest presentation is with an abdominal mass

d. Most commonly present in adolescence

e. They are composed purely of epithelial elements

80. Regarding bladder calculi

a. The incidence has fallen markedly in this country since the late 19th century

b. They may be totally asymptomatic

c. They are more prevalent in patients with chronic urinary sepsis

d. They are associated with squamous metaplasia of the bladder mucosa

e. They increase the risk of transitional cell carcinoma


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